The Physician-Patient Alliance for Health & Safety (PPAHS) released findings on practical solutions to prevent venous thromboembolism (VTE) in patients undergoing hip and knee replacement in its Orthopedic VTE Safety Report.
The survey gathered 41 respondents from across the United States and targeted experts in orthopedics. The majority of respondents indicated that they were either physicians (42.5%) or nurses (32.5%). Those who elected to identify themselves as “Other” largely fell within four self-identified professions: nurse practitioners, physical therapists, program managers, and pharmacists. About 3 in 5 respondents indicated that their primary work setting was in Orthopedics.
According to Michael Wong, JD, Founder and Executive Director of PPAHS:
“The survey indicates that awareness of the risks of VTE following orthopedic surgery are high. Patients go through at least one assessment screening for risk of VTE, with an average of two times. The clinical outcome goal should be targeted at 100% compliance with VTE risk assessment on admission (to establish a baseline) and at multiple points along the patient’s continuum of care until discharge.
“Of note is the level to which prescription for mechanical prophylaxis, such as intermittent pneumatic compression device, drops following discharge; from 78% prior to surgery to 43% prior to discharge. An analysis of the data shows that eligibility for such methods under Medicare Part B could be a key driver in this pattern, with respondents indicating that they would be 34% more likely to prescribe mechanical prophylaxis for their patients if it were covered by Medicare Part B.
“It is clear that the lack of coverage by the CMS has restricted physician options in preventing VTE upon discharge. Nearly seven in ten respondents indicated that they believed that the lack of coverage for mechanical prophylaxis after discharge under Medicare Part B was not in the best interest of the patient. This indicates a strong call from physicians and their patients is needed to have the ability to prescribe the appropriate method for preventing VTE in their patients on an individual basis.”
Hip and knee replacement surgeries are among the most commonly performed procedures in the US. About 1 million of these procedures are performed each year.
The 30-day readmission rate following hip and knee replacement is 4.3% and 3.9% respectively. The readmission rate rises to 7.8% 90-days after surgery.